Health affords us boundless freedom until we no longer have it. It is therefore not surprising that health is always a big election focus for any new government.

Many believe our current health system is in crisis. As a nation we are facing a shortage of health professionals, increasing equity gaps in health outcomes, an ageing population and a health system that is struggling to find its mojo post-reform. While this situation may appear bleak, these challenges provide us with an opportunity to be innovative in the way we address these issues. We therefore eagerly await Budget 2024’s health allocation, intended to deliver significant improvements in health outcomes for all New Zealanders.

The Minister of Finance has been clear in pre-Budget announcements that New Zealand faces a significant fiscal challenge. However, the Government has also promised to increase health funding every year with a relentless focus on life-saving targets and a shift of funding from back-office to frontline resources and services.

While the commitment to frontline staffing is welcome news, in a fiscally constrained environment it means there will be implications in needing to deliver more for less. For example, we’ve already seen the Government revisit the hospital rebuild programme, exploring options for a series of smaller builds rather than large single buildings.

The challenge in front of us will be in demonstrating that the investment we make in additional frontline staffing will achieve better sustainable performance. Health has had significant investment over recent years and while this has helped support the system, it has not resulted in improved health performance – in fact, performance prior to and post-COVID has continued to decline.

While our frontline clinical workforce shortage is undeniable, it is important to acknowledge that we also have systems, processes and aging technologies that do not enable a productive workforce or empower consumers to take more ownership of their healthcare journeys. The World Health Organisation forecasts predict a shortfall of ten million health workers by 2030. Simply put, the current strategy of recruiting from a global pool is unsustainable and throws New Zealand into a fiercely competitive talent quest.

To address our productivity and workforce shortages, we need to find smarter ways to support and augment the workforce and drive efficiency gains. This transformation will require more than just automating what we do today. We need to challenge the status quo, rearchitect the way we work, who performs this work, where this work is done, and deliberately design with a relentless focus on customer experience.

One such movement that is gaining traction around the globe is Professor Martin Curley and Ireland’s Stay Left, Shift Left, 10X strategy. This talks to the need for technologies and solutions that deliver 10X the improvement across patient outcomes, cost, and workforce efficiencies.

Broadly, the concept relates to keeping people out of emergency and elective care and shifting people to the preventative, proactive side of the care continuum. The key to achieving this is digital enablers that don’t just provide marginal gains around the edges but fundamentally change the game, with 10X the impact and a marked reduction in the overall cost of care.

Shifting left also brings with it a more informed and empowered health consumer with a stronger voice in directing their own care model. In Deloitte’s 2024 Global Health Care Sector Outlook, consumers navigate their own health, alongside digital transformation, powered by interoperable data, open secure platforms, and innovative technologies. The question is, will Budget 2024 provide our nation with adequate investment to support these digital enablers and drive this transformation to a more proactive health system?

The great news is these innovative digital enablers are available today and significant progress has already been made by Health New Zealand in implementing technology during COVID-19 that is now being repurposed for wider public health benefit. For example, artificial intelligence (AI) solutions reducing administrative demand, and innovative screening technology and testing tools that are enabling earlier access to lifesaving care.

History has shown organisations that invest in strategically improving their efficiency and effectiveness during times of economic constraint are better prepared than those that simply focus on costs and increasing demands on workforce. We are at a time where disruptive technology such as AI and robotic process automation (RPA) are poised to free up clinical capacity, transform the efficiency of service provision, and enable consumers to engage with our health system more easily.

Furthermore, this Government has signalled an increased focus on data to inform investment decisions. This approach can also be used to unlock efficiencies, anticipate service demand, identify at-risk patient populations, and optimise resource allocation.

This data-driven approach aligns with the Government's emphasis on social investment, ensuring healthcare resources are directed efficiently to address societal needs. Revisiting and scaling the role of social care will also be key. Location of residence, quality of social support networks, and exposure to stress can have powerful effects on well-being. It is estimated that 80% of health outcomes depend on behavioural, social, or environmental drivers of health.

Health systems that focus on delivering “sickness services” are on a path to being fiscally unsustainable. In New Zealand, we cannot keep increasing funding to cater to increasing demand. We need health and social care systems geared to keeping people well – the Government’s commitment to social investment provides an exciting opportunity to begin this process. 

Deloitte’s 2024 Global Health Care Sector Outlook provides further detail on the challenges the government is responding to:

• The need to transform health care with artificial intelligence
• Addressing cost and affordability
• Responding to the looming global shortfall in health care workers
• The need for an expanded role of social care
• A more sustainable future. 

And with a final nod to our health workforce, this year’s Health Reimagined: Voice of the Workforce report from Deloitte Australia highlights:

• Engaging the workforce in system redesign and healthcare of the future discussion is key to redesigning the work in a clinically safe manner and utilising emerging technologies such as AI to enable new ways of working.
• There is an opportunity to work with frontline clinicians to understand which tasks could easily be re-distributed to other roles, new roles or technology e.g., Generative AI, while not impacting on patient care and safety.
• Implementing new workforce models that will redirect indirect patient care and better systems to reduce the administrative burden so clinicians can increase time spent with patients.

This Government has placed a strong emphasis on the need to demonstrate value from public expenditure. If the focus of Budget 2024 for healthcare is tangible delivery of value and outcomes, and delivering more with less, then innovative technologies that reduce cost and waste and free up our talented workforce to care are central to our success.